Nivel de estrés y estrategias de afrontamiento utilizadas por estudiantes de la licenciatura en Enfermería

Objective: Determine the relationship between the stress level and the coping strategies used by students of the Bachelor’s Degree of Nursing in institutions of higher education of Ciudad Obregón, Sonora. Methodology: Descriptive and correlational study; the population was comprised by 250 students whose age ranged from 18 and 46 years. Data was collected through a questionnaire of sociodemographic characteristics, the perceived stress level instrument, and the Brief COPE questionnaire.Results: 74.4% of the sample was comprised by women and 25.6% by men. It was found that both genders had a moderate level of stress (78%), in terms of the coping strategies most frequently used by the students, the emotional active coping was the one found. The correlation analysis was performed using Pearson's chi-square non-parametric test (x2) to probe the existence of relationship between the stress level and coping strategies (p=0.67). Based on the results of x2 (p=0.067), an additional analysis was carried out separating the categories of each one of the variables of study; Pearson’s test was used to find a significant correlation between low stress level and active emotional coping strategy (p=0.27) and between high stress level and avoidance emotional coping strategy (p=-0.01).Conclusions: The highest levels of stress are manifested by students who study only theoretical subjects. It is suggested the implementation of interventions related to the adequate management of stress. Objetivo: Determinar la relación entre el nivel de estrés y las estrategias de afrontamiento utilizadas por estudiantes de la Licenciatura en Enfermería en Instituciones de Educación Superior (IES) de Ciudad Obregón, Sonora.Metodología: Estudio no experimental y correlacional; se empleó un muestreo probabilístico estratificado de 250 estudiantes, con edades entre los 18 y 46 años de edad. Los datos fueron recabados mediante un cuestionario de características sociodemográficas, el instrumento del nivel de estrés percibido y para medir afrontamiento el Brief COPE Inventory. Resultados: El 74.4% de la muestra fueron mujeres y el 25.6% hombres, ambos géneros exhibieron nivel de estrés moderado (78%), la estrategia de afrontamiento reportada con mayor frecuencia fue afrontamiento activo emocional. Se empleó la prueba no paramétrica chi-cuadrada de Pearson (χ2) para probar la existencia de asociación entre el nivel de estrés y las estrategias de afrontamiento (p= 0.67). Con base a los resultados de χ2 (p=.067) se realizó un análisis adicional separando las categorías de cada una de las variables de estudio, se utilizó la prueba de Pearson con la cual se encontró correlación significativa entre el nivel de estrés bajo y la estrategia afrontamiento activo emocional, (p=0.27) y entre nivel de estrés alto y estrategia de afrontamiento emocional por evitación (p=-.01).Conclusiones: Los niveles más altos de estrés lo manifiestan estudiantes que cursan solo materias teóricas. Se sugiere la implementación de intervenciones relacionadas al manejo adecuado del estrés.

Working Mode and Physical Activity as Factors Determining Stress and Sleep Quality during COVID-19 Pandemic Lockdown in Poland

The coronavirus pandemic and related government restrictions have a significant impact on peoples’ everyday functioning and working, which influences their physical and mental health. The aim of the study was to examine the associations between stress and sleep quality of people of different working modes: working in the workplace (WP), working remotely (RW), and nonworking (NW) in relation to their physical activity (PA) during COVID-19 pandemic lockdown in Poland. It was an online survey performed during governmental lockdown in April 2020. The data were collected form 1959 adults using International Physical Activity Questionnaire—Short Form (IPAQ-SF), Pittsburgh Sleep Quality Index (PSQI), and Perceived Stress Scale (PSS). The conducted analysis included t-Student test, analysis of variance (ANOVA), and mediation analysis (MANOVA). A moderate level of stress was reported in 57% of participants, and 34% of them reported a high stress level. Poor sleep quality was reported in 64% of participants. Total PA performed daily was, on average, 184.8 ± 170.5 min/day for WP, 120.6 ± 124.4 min/day for RW, and 124.6 ± 114.7 min/day for NW (p < 0.001). There was a relationship observed between the stress and sleep quality vs. PA habit and working mode, with p < 0.05. Being physically active can be beneficial to perceive less stress and sleep disturbances influencing sleep quality, especially in remotely or nonworking people. Planning future pandemic restrictions, the policymakers should be aware of the appropriate guidelines of work planning and PA recommendations for people of different working modes.

High level of perceived stress among essential workers during the COVID 19 lockdown in a Nigerian state

Background: COVID-19 pandemic caused unexpected socio-economic changes globally. This study determined the prevalence and factors associated with perceived stress among essential workers during the COVID-19 lockdown in Ekiti State, Nigeria.Method: A cross-sectional descriptive study that involved 588 essential workers in Ekiti State, Nigeria during the COVID-19 lockdown. The Perceived Stress Scale was used in the study Chi-square test of statistical significance and multivariate analysis using binary logistic regression were used in the analysis and the level of statistical significance was determined by a p-value of <0.05.Results: The prevalence of high perceived stress levels among all the respondents, health workers, and non-health workers were 64.1% (63.3-70.6), while health workers and non-health workers had a prevalence of 70.1% (65.5 -73.3) and 56.5% (23.5-38.7) respectively. The majority of the respondents related their sources of stress to inadequate transportation (63.3%), hearing of COVID related news (47.4%), and lack of finance (55.1%). Using Logistic Regression respondent respondents who were not satisfied with the support they received from the government during the pandemic had three fold high stress levels than respondents who were satisfied with the support received from the government [AOR= 3.228, (CI= 1.771- 5.886)]. Furthermore, the odd of the high stress level was one fold increased among male respondents than female respondents [AOR = 1.08 CI= (1.410-6.215). Conclusion: Stress management is recommended given the high-stress level among essential workers. French title: Niveau de stress perçu chez les travailleurs essentiels pendant le casanier du COVID-19 dans l'état d'Ekiti, au Nigéria Contexte général de l'étude : La pandémie de COVID-19 a provoqué des changements socio-économiques inattendus dans le monde. Cette étude a déterminé la prévalence et les facteurs liés au stress perçu à un niveau parmi les travailleurs essentiels pendant la période de confinement du COVID-19 dans l'état d'Ekiti, au Nigéria.Méthode de l'étude : Une étude descriptive transversale qui a impliqué 588 travailleurs essentiels dans l'état d'Ekiti, au Nigéria, dans le cadre du confinement COVID-19. L'échelle de stress perçu a été utilisée dans le test du Chi carré de l'étude et une analyse multi variée a été utilisée. Le niveau statistiquement significatif a été déterminé par une valeur p < 0,05.Résultats de l'étude: Le total des répondants non-agents de santé et agents de santé présentait une prévalence de niveaux élevés de stress perçu de 64,1% (63,3-70,6), 56,5% (23,5-38,7) et 70,1% (65,5 - 73,3). La majorité des répondants ont lié leurs sources de stress à un transport inadéquat (63,3 %), à l'audition de nouvelles liées à COVID (47,4 %) et au manque de financement (55,1 %) En utilisant la régression logistique, les répondants qui étaient insatisfaits du soutien gouvernemental pendant la pandémie avaient des niveaux de stress trois fois plus élevés que les répondants qui étaient insatisfaits du soutien gouvernemental [AOR= 3.228, (IC= 1.771-5.886)]. De plus, l'impair du niveau de stress élevé était un fois plus élevé chez les hommes interrogés que chez les femmes [AOR = 1,08 IC = (1,410-6,215).Conclusion : La gestion du stress est recommandée étant donné le niveau de stress élevé chez les travailleurs essentiels.

The Atopic Dermatitis Control Tool, A High-Performance Tool for Optimal Support

The evaluation of global atopic dermatitis control is key to minimizing the disease burden. The Atopic Dermatitis Control Tool (ADCT) has been developed for this purpose. Participants [diagnosed by a physician] were recruited using a real-life methodology and asked to answer a questionnaire to provide sociodemographic and personal information. The ADCT algorithm described by Pariser was used to categorize patients as having controlled or uncontrolled atopic dermatitis. Data were collected on 1606 patients. The patients’ median age was 40 quartiles [31, 42.45] years, and 1,023 (63.7%) patients were women. A total of 1,146 (71.4%) patients did not have controlled atopic dermatitis according to the ADCT score. Patients with uncontrolled disease were at a significantly higher risk of a high stress level and had more opportunities to miss work than patients with controlled disease. In this study, we showed that a key factor for predicting the disease burden is patient self-assessed disease control in terms of multiple dimensions: stress, sleep, quality of life, work absenteeism and loss of productivity.

The COVID-19 Global Pandemic and Its Impact on the Mental Health of Nurses in Malaysia

The Coronavirus disease 2019 (COVID-19) global pandemic since its onset has had a dramatic and often devastating impact, both physical and psychological, on all healthcare workers. This study aimed to assess the impact of psychological distress that COVID-19 has on nurses, as well as the coping strategies that they employed. This is a cross-sectional national online survey. A total of 859 nurses actively involved in caring for patients with suspected or confirmed COVID-19 in Malaysia participated in the study. More than three-quarters of the nurses experienced stress (77.2%). A total of 88.7% and 7.2% of nurses revealed a moderate and high stress level, respectively. Approximately one in eight (12.1%) nurses reported feeling depressed. Nurses working in the outpatient departments reported significantly higher stress levels than nurses working in inpatient care departments. Nurses having chronic health problems reported significantly higher depression levels than nurses with no chronic health problem. Highly stressed or depressed nurses tend to adopt avoidance coping strategies while religion and emotional support were used regardless of the stress or depression levels experienced. The findings of the study provide insight into the mental health and coping strategies of nurses actively involved in caring for patients with suspected or confirmed COVID-19 in Malaysia. This would be of tremendous help to nursing administrators in implementing mental health services for nurses during and following the COVID-19 global pandemic.

Immediate versus delayed frozen embryo transfer in women following a failed IVF-ET attempt: a multicenter randomized controlled trial

Background The optimal time at which to perform a frozen-thawed embryo transfer (FET) following a failed in-vitro fertilization-embryo transfer (IVF-ET) attempt remains elusive to most reproductive experts. Physicians often delay the introduction of FET due to concerns related to potential residual effects of ovarian hyperstimulation which may interfere with the regular menstrual cycle. Moreover, given that most of the published studies on the topic are retrospective and have inconsistent findings, it is crucial to develop evidence-based randomized control guides for clinical practice. Therefore, this well-designed randomized controlled trial (RCT) was conducted to determine whether it is necessary to delay FET for at least one menstrual cycle after the failure of fresh embryo transfer. Methods Infertile women eligible for IVF-ET were invited to participate in this multicenter, randomized, non-inferiority, parallel-group, unblinded, controlled trial at the academic fertility centers of four public hospitals in Chinese Mainland. Infertile women scheduled to receive their first FET cycle after a failed IVF-ET attempt were randomly assigned to either (a) the immediate FET group in which FET was performed in the first menstrual cycle following the failed IVF-ET cycle (n = 366) or (b) the delayed FET group in which FET was performed in the second or subsequent menstrual cycle following the failed IVF-ET cycle (n = 366). All FET cycles were performed during hormone replacement cycles for endometrial preparation. The primary outcome was the ongoing pregnancy, defined as a detectable fetal heart beat beyond twelve weeks of gestation. Secondary outcomes were other pregnancy-related outcomes, maternal and neonatal complications. Analysis was performed by both intention-to-treat and per-protocol principles. Results A total of 646 FETs were completed. The frequency of moderate to severe depression and high stress level prior to FET in delayed FET group were significantly higher than that in immediate FET group (10.6% vs 6.1%, p = 0.039; 30.3% vs 22.4%, p = 0.022, respectively). Immediate FET resulted in a higher frequency of clinical pregnancy than did delayed FET (41.7% vs 34.1%), for a relative risk (RR) of 1.23 (95% confidence interval [CI], 1.00–1.50; p = 0.045). Women who underwent immediate FET also had a lower frequency of biochemical pregnancy loss (11.7% vs. 30.6%), with a RR of 0.28 (95% CI 0.23–0.63, p < 0.001), and a higher frequency of embryo implantation (25.2% vs. 20.2%), with a RR of 1.25 (95% CI 1.01–1.53; p = 0.038). Although the ongoing pregnancy and live birth rates did not differ significantly between the immediate FET and delayed FET groups (37.1% vs 30.3%, RR 1.22, 95% CI 0.99–1.52, p = 0.067; 36.5% vs 30.0%, RR 1.22, 95% CI 0.98–1.52, p = 0.079, respectively), a multivariate logistic regression analysis adjusted for potential confounders such as depression and stress levels revealed that the immediate FET group had a significantly higher ongoing pregnancy and live birth rates than the delayed FET group (odds ratio 0.68, 95% CI 0.47–0.99, p = 0.041; odds ratio 0.67, 95% CI 0.46–0.96, p = 0.031). The risks of maternal and neonatal complications were comparable between the two groups. Conclusions In women with a previous failed IVF-ET attempt, immediate FET resulted in higher ongoing pregnancy and live birth rates than delayed FET. These findings warrant caution in the indiscriminate application of a delayed FET strategy when apparent risk of high stress level is perceived. Trial registration ChiCTR2000033313.

Immediate versus delayed frozen embryo transfer in women following a failed IVF-ET attempt: a multicenter randomized controlled trial

Background The optimal time at which to perform a frozen-thawed embryo transfer (FET) following a failed in-vitro fertilization-embryo transfer (IVF-ET) attempt remains elusive to most reproductive experts. Physicians often delay the introduction of FET due to concerns related to potential residual effects of ovarian hyperstimulation which may interfere with the regular menstrual cycle. Moreover, given that most of the published studies on the topic are retrospective and have inconsistent findings, it is crucial to develop evidence-based randomized control guides for clinical practice. Therefore, this well-designed randomized controlled trial (RCT) was conducted to determine whether it is necessary to delay FET for at least one menstrual cycle after the failure of fresh embryo transfer. Methods Infertile women eligible for IVF-ET were invited to participate in this multicenter, randomized, non-inferiority, parallel-group, unblinded, controlled trial at the academic fertility centers of four public hospitals in Chinese Mainland. Infertile women scheduled to receive their first FET cycle after a failed IVF-ET attempt were randomly assigned to either (a) the immediate FET group in which FET was performed in the first menstrual cycle following the failed IVF-ET cycle (n = 366) or (b) the delayed FET group in which FET was performed in the second or subsequent menstrual cycle following the failed IVF-ET cycle (n = 366). All FET cycles were performed during hormone replacement cycles for endometrial preparation. The primary outcome was the ongoing pregnancy, defined as a detectable fetal heart beat beyond twelve weeks of gestation. Secondary outcomes were other pregnancy-related outcomes, maternal and neonatal complications. Analysis was performed by both intention-to-treat and per-protocol principles. Results A total of 646 FETs were completed. The frequency of moderate to severe depression and high stress level prior to FET in delayed FET group were significantly higher than that in immediate FET group (10.6% vs 6.1%, p = 0.039; 30.3% vs 22.4%, p = 0.022, respectively). Immediate FET resulted in a higher frequency of clinical pregnancy than did delayed FET (41.7% vs 34.1%), for a relative risk (RR) of 1.23 (95% confidence interval [CI], 1.00-1.50; p = 0.045). Women who underwent immediate FET also had a lower frequency of biochemical pregnancy loss (11.7% vs. 30.6%), with a RR of 0.28 (95% CI 0.23–0.63, p < 0.001), and a higher frequency of embryo implantation (25.2% vs. 20.2%), with a RR of 1.25 (95% CI 1.01–1.53; p = 0.038). Although the ongoing pregnancy and live birth rates did not differ significantly between the immediate FET and delayed FET groups (37.1% vs 30.3%, RR 1.22, 95% CI 0.99–1.52, p = 0.067; 36.5% vs 30.0%, RR 1.22, 95% CI 0.98–1.52, p = 0.079, respectively), a multivariate logistic regression analysis adjusted for potential confounders such as depression and stress levels revealed that the immediate FET group had a significantly higher ongoing pregnancy and live birth rates than the delayed FET group (odds ratio 0.68, 95% CI 0.47–0.99, p = 0.041; odds ratio 0.67, 95% CI 0.46–0.96, p = 0.031). The risks of maternal and neonatal complications were comparable between the two groups. Conclusions In women with a previous failed IVF-ET attempt, immediate FET resulted in higher ongoing pregnancy and live birth rates than delayed FET. These findings warrant caution in the indiscriminate application of a delayed FET strategy when apparent risk of high stress level is perceived.

A Comparative Study of Physiological and Physical Parameters Between Married Females Residing at The Qushtapa Refugee Camp and in The City of Erbil in Kurdistan-Iraq

Refugees are under a high-risk factor of being suffering from many different diseases due to the uncontrolled accommodations environment of the camps. This study aimed to test whether the camp's habitat affecting the physical activities of the married females as a biomarker of the adverse effects on the health management issues. 60 married females (30 refugees and 30 city residents) were recruited. Blood samples of all participants were analyzed for blood glucose, blood triglycerides, blood cholesterol, blood hemoglobin (HGb), blood heamatocrite percentage (HCT %) and other physical parameters estimated like body mass index (BMI), mean arterial pressure (MAP). Additionally, participants were screened for bacterial UTIs. Refugees married females showed a significant decrease in the blood hemoglobin concentration (gm/dl) compared with the city females (P= 0.014) and blood heamatocrite percentage (HCT %) (P= 0.0074). Also, no significant differences were observed for the other parameters between refugees married females and city married females. The UTI bacterial infection in refugees married females (21, 65.6%) was significantly higher than the infection among city resident married females (11, 34.4%) (P=0.0096). The higher incidence percentage of UTIs were caused by Gram-negative bacteria (87.5%). The most dominant pathogen which established UTIs was Escherichia coli (57%). A high-stress level of camp environment and nutritional malformation may affect the refugees married females more than the city females. Therefore, it is the international community responsibility to protect and provide life-saving assistance to all refugee women and to those that have been subjected to such situations.

Clinical predictors of cybersickness in virtual reality (VR) among highly stressed people

The use of virtual reality (VR) in the treatment of psychiatric disorders is increasing, and cybersickness has emerged as an important obstacle to overcome. However, the clinical factors affecting cybersickness are still not well understood. In this study, we investigated clinical predictors and adaptation effect of cybersickness during VR application in highly stressed people. Eighty-three healthy adult participants with high stress level were recruited. At baseline, we conducted psychiatric, ophthalmologic, and otologic evaluations and extracted physiological parameters. We divided the participants into two groups according to the order of exposure to VR videos with different degrees of shaking and repetitively administered the Simulator Sickness Questionnaire (SSQ) and the Fast Motion sickness Scale (FMS). There was no significant difference in changes in the SSQ or the FMS between groups. The 40–59 years age group showed a greater increase in FMS compared to the 19–39 years age group. Smoking was negatively associated with cybersickness, and a high Positive Affect and Negative Affect Schedule score was positively associated with cybersickness. In conclusion, changing the intensity of shaking in VR did not affect cybersickness. While smoking was a protective factor, more expression of affect was a risk factor for cybersickness.

Female Caregivers Stress in Caring for Hospitalized Elderly with Chronic Disease at Universitas Sumatera Utara Hospital: A Phenomenology Study

The elderly is prone to suffer from physical illness and experience hospitalization due to physiological decline. Researches showed that the majority of the family caregivers are females, who are responsible for the caregiving delivery.This study aims to explore the female caregiver stress caring for hospitalized elderly with chronic illness at USU Hospital, Medan. This research is a qualitative study with a phenomenological approach. The sampling technique was the purposive sampling method with several criteria; female with mild to high stress level, the prominent caregivers in the family, and had been caring the elderly for more than 1 year. The female caregivers would be assessed for stress levels with the Zarit Burden Inventory instrument, which is commonly used to assess the stress burden of caregivers caring for the elderly. The data collection is conducted through in-depth interview. The data are transcribed and analysis for sub-theme and theme. The research result found nine participants with an age range of 32-67 years. All participants are the elderly daughter’s and spouses. The stress score is 15-25 which means that the participants are experiencing mild-moderate to severe stress ranges. The thematic analysis revealed four main themes namely; (1) Financing elderly, (2) Caregiver fatigue, (3) Experiencing negative relationship, and (4) Indonesian culture associated with female gender. According to the research result, it should be a basis data for further research related to the elderly caregivers. Therefore, the need for the specific interventions is provided for the elderly and the caregivers who are vulnerable to stressful conditions.